Asthma UK Centre for Applied Research, Institute of Population Health Sciences, Barts and the London, School of Medicine and Dentistry, Queen Mary, University of London, UK.
Asthma UK Centre for Applied Research, Usher Institute, The University of Edinburgh, UK.
Br J Health Psychol. 2021 Nov;26(4):1040-1068. doi: 10.1111/bjhp.12518. Epub 2021 Mar 16.
Intervention development guidelines suggest that behavioural interventions benefit from being theory-based. Minority populations typically benefit less from asthma self-management interventions, and the extent to which appropriate theory has been used for culturally tailored interventions has not been addressed. We aimed to determine theory use and theoretical domains targeted in asthma self-management interventions for South Asian and Black populations.
We systematically searched electronic databases, research registers, manually searched relevant journals and reference lists of reviews for randomised controlled trials of asthma self-management for South Asian and Black populations, and extracted data using the Theory Coding Scheme to inform if/how theory was used and explore its associations with asthma outcomes, and the Theoretical Domains Framework was used to identify targeted theoretical domains and its relationship to effectiveness of asthma outcomes.
20 papers (19 trials) were identified; theory was not extensively used in interventions. It was unclear whether theory use or theoretical domains targeted in interventions improved asthma outcomes. South Asian interventions included 'behavioural regulation', while 'reinforcement' was mostly used in African American interventions. 'Knowledge' was central for all populations, though there were differences related to 'environmental context and resources' e.g., language adaptations for South Asians; asthma resources provided for African Americans. Author descriptions of interventions targeting providers were limited.
There was little evidence of theory-based approaches used in cultural interventions for asthma self-management. Demystifying theoretical concepts (and cultural interpretations of constructs) may provide clarity for 'non-experts', enabling mainstream use of theory-driven approaches in intervention development.
干预措施开发准则表明，行为干预措施受益于基于理论。少数群体通常从哮喘自我管理干预中获益较少，而且针对文化调整的干预措施是否适当使用了理论也尚未得到解决。我们旨在确定针对南亚和黑人人群的哮喘自我管理干预措施中使用的理论和针对的理论领域。
我们系统地搜索了电子数据库、研究登记处、手动搜索了相关期刊和综述的参考文献，以寻找针对南亚和黑人人群的哮喘自我管理的随机对照试验，使用理论编码方案提取数据，以了解理论是否以及如何被使用，并探讨其与哮喘结果的关系，还使用了理论领域框架来确定针对的理论领域及其与哮喘结果有效性的关系。
确定了 20 篇论文（19 项试验）；干预措施并未广泛使用理论。理论的使用或干预措施针对的理论领域是否改善哮喘结果尚不清楚。南亚干预措施包括“行为调节”，而“强化”主要用于非裔美国人的干预措施。“知识”对于所有人群都是核心的，但也存在与“环境背景和资源”相关的差异，例如南亚人需要语言适应；为非裔美国人提供哮喘资源。针对提供者的干预措施的作者描述有限。
针对哮喘自我管理的文化干预措施中几乎没有基于理论的方法的证据。阐明理论概念（以及文化对结构的解释）可能会为“非专家”提供清晰的认识，从而使基于理论的方法在干预措施的发展中得到更广泛的应用。
